摘要
美国食品与药品监督管理局(FDA)已批准抗CD19嵌合抗原受体(chimeric antigen receptor,CAR)T细胞axicabtagene cilo⁃leucel、tisagenlecleucel用于复发/难治性弥漫性大B细胞淋巴瘤(recurrent/refractory diffuse large B-cell lymphoma,r/r DLBCL)的治疗,但该疗法易发生一系列不良反应,包括急性毒性细胞因子释放综合征、免疫效应细胞相关神经毒性综合征和噬血细胞综合征,长期毒性如血细胞减少症和B细胞发育不全,以及少见不良反应。本文主要介绍细胞因子释放综合征及免疫效应细胞相关神经毒性综合征的发病机理、临床表现、分级与处理、危险因素与预防措施,同时对血细胞减少症、B细胞耗竭在内的延迟毒性及少见不良反应做出综述。
The Food and Drug Administration has approved anti-CD19 chimeric antigen receptor T cells,namely axicabtagene ciloleucel and tisagenlecleucel,for treating relapsed/refractory diffuse large B-cell lymphoma(r/r DLBCL).However,this therapy is associated with a series of toxicities(acute and late)and rare adverse events.Acute toxicities mainly comprise cytokine release syndrome(CRS),immune effector cell‐associated neurotoxicity syndrome(ICANS),and hemophagocytic syndrome,whereas long-term toxicities include cytopenia,B-cell aplasia,and hypogammaglobulinemia.This review will mainly discuss the pathogenesis,clinical manifestations,classification and management,risk factors,and prophylactic measures of the two most common toxicities CRS and ICANS.In addition,late toxicities and rare adverse events will be reviewed.
作者
王晋秋
邹立群
Jinqiu Wang;Liqun Zou(West China School of Medicine,Sichuan Univercity,Chengdu 610041,China;Department of Head and Neck Oncology,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2020年第17期912-918,共7页
Chinese Journal of Clinical Oncology
